Lava tubes play a pivotal role in the formation of many lava flow fields. A detailed examination of several compound ‘a‘a lava flow fields on Etna confirmed that a complex network of tubes forms at successively higher levels within the flow field, and that tubes generally advance by processes that include flow inflation and tube coalescence. Flow inflation is commonly followed by the formation of major, first-order ephemeral vents which, in turn, form an arterial tube network. Tube coalescence occurs when lava breaks through the roof or wall of an older lava tube; this can result in the unexpected appearance of vents several kilometers downstream. A close examination of underground features allowed us to distinguish between ephemeral vent formation and tube coalescence, both of which are responsible for abrupt changes in level or flow direction of lava within tubes on Etna. Ephemeral vent formation on the surface is frequently recorded underground by a marked increase in size of the tube immediately upstream of these vents. When the lining of an inflated tube has collapsed, ‘a‘a clinker is commonly seen in the roof and walls of the tube, and this is used to infer that inflation has taken place in the distal part of an ‘a‘a lava flow. Tube coalescence is recognised either from the compound shape of tube sections, or from breached levees, lava falls, inclined grooves or other structures on the walls and roof. Our observations confirm the importance of lava tubes in the evolution of extensive pahoehoe and ‘a‘a flow fields on Etna.